Human Rights Watch (HRW) has revealed that some public hospitals and private clinics in China are making patients endure "gay conversion" therapy to re-orient their sexuality. However, analysts say it is mostly pressure from parents that is responsible, rather than government policy. Parents wanted their children to be made to conform to social expectations, not least through the institution of traditional marriage. But according to HRW, none of 17 individuals it interviewed gave "free and informed" consent because they had been subjected to personal pressure. Many were given electro-shock therapy and medication, orally or by injection, which was unknown to them.

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None of those who endured the conversion therapy were expected to file complaints. Some were afraid of the repercussions of having their sexual orientation made public. China decriminalized homosexuality more than 20 years ago and declassified homosexuality as a mental illness in 2001. A revision of China’s Mental Health Law in 2013 made conversion therapy illegal. Gay conversion was years ago condemned internationally, including as a breach of a United Nations convention against torture. Maya Wang, a senior researcher at HRW, said it was difficult for lesbians, gays, bisexuals and transsexuals (LGBT) to seek official redress over discrimination. China has no discrimination laws in place for sexual orientation or gender identity. Professional psychiatric and psychological associations had not prohibited lucrative conversion clinics, Wang said. Conversion therapy globally is often linked to fundamentalist Christian groups. But the fundamentalist Christian aspect is not significant in China. Emmanuele Lazzara, an expert in social attitudes towards sexual minorities in China, said various other social pressures are more relevant. Despite the lack of a strong and influential Christian community, homosexuality is still considered to be a disease by a large number of people, Lazzara explained. While a recent survey conducted by Chinese LGBT activists found that only 2 per cent of their sample supported the pathological view of homosexuality, Lazzara doubts the figures. He suggests that the real level holding this view is likely higher because the survey sample was statistically questionable. "I would estimate that probably the majority of Chinese people still hold the belief that homosexuality is somewhat abnormal," Lazzara said. Many of his own research participants held this view, especially older people and rural folk. "In fact, it make sense that parents would want to see a doctor when they find out that their children are, as they believe, sick," Lazzara said. They resorted to conversion clinics out of concern, especially as marriage in China is still pretty much a universal practice. Most of those interviewed by HRW entered a clinic to treat their homosexuality because of intense pressure from their parents. For some doctors, parents’ willingness to conform their children to Chinese social norms is easy to exploit. "Conversion therapy is a big business," Lazzara said. "I have spoken to a Chinese activist who confirmed this… parents are often willing to pay huge sums of money to 'fix' their child." Lazzara is pursuing a PhD at the University of Nottingham, England, on sexual orientation attitudes in China. In Hong Kong — where fundamentalist Christian groups are influential at high levels of government — gay conversion therapy is not discouraged by the administration. The VICE media outlet revealed earlier this year that the Hong Kong government trained and sponsored its social workers in a practice known by the acronym SAFE-T. Sexual Attraction Fluidity Exploration Therapy is referred to by supporters as applying to people who want to stem their feelings of same-sex attraction. The Hong Kong government has openly funded a group called "Post Gay Alliance," a fundamentalist Christian group that espouses SAFE-T. Lazzara pointed to a recent survey finding in China that 73 percent of medical practitioners interviewed believed that some people's sexual orientation could be changed and 14 percent believed that all people's sexual orientation could be changed. Most medical practitioners in the same sample believed, to various degrees, that homosexuality is due to external factors such as media propaganda, the influence of one's peers and family upbringing. In summary, both the opportunity for profit and the intense pressure to conform to traditional social norms is likely to explain why there is still gay conversion therapy in China, despite the lack of fundamentalist Christian groups. While Beijing is generally apathetic towards LGBT rights, the government has no tolerance for dissent, including marches or protests. Such official hostility extends to any LGBT activists openly campaigning for change.